Federal Healthcare Fraud Penalties

If you’re facing federal health care fraud charges, it’s important to know what sort of penalties are associated with various types of convictions.  In this page, we give a very basic outline of the possible penalties and repercussions an individual could face across a spectrum of health care fraud charges.  If you’d like to learn more about how these potential consequences apply to your particular case, please call our law offices and ask to speak to a federal health care fraud lawyer in Washington, DC.

Misdemeanor vs. Felony Health Care Fraud Charges

If an individual is convicted of a misdemeanor, he or she can expect to pay a small fine and repay any kind of ill-gotten gains, meaning that restitution must be paid back. In these situations, incarceration usually does not exceed a year.

However, in a federal health care fraud case, the government is not going to aim for a misdemeanor conviction—the government is seeking convictions for felonies. A felony conviction could result in possibly decades in prison, fines in hundreds of thousands of dollars, and restitution and forfeiture that could escalate into the millions of dollars.

What Factors Go Into Determining Penalties?

Penalties are determined in a federal case by the application of the federal sentencing guidelines. These guidelines used to be mandatory, but for some years now they have simply been “advisory,” meaning that the federal judge does not have to strictly apply these guidelines, which set forth what the range of penalties should be for this particular defendant in this particular case based upon the conduct in the case, the role the individual had in that conduct, and that individual’s criminal background and criminal history.

Even though the guidelines are no longer mandatory and are advisory, federal judges typically still rely extremely heavily on those guidelines. This means that the following items can and will be used in order to determine how penalties for a health care fraud conviction are determined:

  • The amount of money involved
  • The lengths of time the scheme was going on
  • The number of people participating in the scheme
  • That particular defendant’s role in the scheme
  • The criminal history of those involved

These elements will all be used by the judge to determine what the appropriate sentence should be—whether that be probation, probation with some incarceration, or prison.

Common Health Care Fraud Sentences

In federal court, incarceration is extremely common—much more so than you see in the state court. Individuals expect to see for a first time conviction some level of incarceration, followed by supervised release (which used to be called parole and is similar to probation).

In a situation where someone submitted an isolated false claim and it was not for a large amount of money, and if they either accepted responsibility early or assisted the government in explaining exactly what happened and who was involved, that person may receive a more lenient sentence perhaps just probation.  However, in the vast majority of cases, the individual convicted of a fraudulent scheme to defraud the federal government in its programs can expect to spend some time in prison.

Call a Federal Health Care Fraud Lawyer Today

Facing serious penalties can be intimidating, but there are many defense strategies that may be applied in order to lessen federal health care fraud charges or have them completely dropped.  To learn about how you can begin taking steps in the right direction, contact a DC federal health care fraud attorney today.